Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00211
� DEVELOPMENT S DATE ISSUED: 4/1/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S135DC -00400
SITE ADDRE 11795 SW GREENBURG RD ZONING: C -P
SUBDIVISION: TIGARDVILLE PARK LOT : 008 JURISDICTION: TIG
Project Description: Alteration of existing 120v servie #TGO5c2
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BLACK, STEVEN W + MELISSA R DRYER ELECTRIC INC
2511 PALISADES CREST DR 9409 NE.COLFAX ST
LAKE OSWEGO, OR 97034 PORTLAND, OR 97220
Phone: 503 - 639 - 4201 Phone: 503 - 771 - 5667
FEES Reg #: ELE 26-1142C
Description Date Amount LIC 153466
SUP 2876S
[ELPRMT] ELC Permit 4/1/2005 $80.30
[TAX] 8% State Surcharge 4/1/2005 $6.42 REQUIRED ITEMS AND REPORTS
Total $86
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: D -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03 13:48 FROM- T-933 P.023/043 F-594
c2/01/2005 15:12 FAX 5035981960 CITY OF 116Axii ..... - - -
ik.
4
Electrical Permit Application *- . iFiAt.1.111 I.: USE: (.■N 1.1'
i. of T Igird 0
.
IA lighgerg506" • . I Pentair rre,.:i4c9,..005-.6C;Ati
, i25 sW Halt Blvd., Tigard, OB. 223 97 . lin Review
ce: 503.6: 9.4.171 Fax: $03.598,19 1fi
60 .44. ''. 'i •\ OthCr Pelnie 1
'1.1 Dacca :
`---riSpection Linz 503. 1'.1..,.
09.4175 .. 12 Pete Ready/By: --- - Jurit, 53 sse Pagal2 tor
:71ternet wo•o tigard.or.us Neettle4VMstoeth l , SuPPlarnectin Information !
------ -
7.T.' rs•-sr -. , :.-, ,, ,, , ,--7,:; ,,, , , -.- -, ..:, , :-:• , :-.,Tri , ---.--1,7-, ,, ...... ,, ..-:-./70,...,- , .17.7 , :0-..,:i..1 it PieWP q'• s W9i,t l ft r jr -r-7--.--V-
.:-, ' - ' 511- -."-'' , ', . ''.:,.. ,, :: '.: ;..',..:: ' • ':,■.: '::::, ,.,...,...<, .5-1;:alta2.Y1.
7 New cons tru dice El Additio r alteration/replacornent Please chock ell 'h.:. ILT.,ply:
ElServiee ov< ..- 225 anape, comml Elklazarclou; location
: Dcmolititn El Otber:
_. 3_ 1:1 ervice ovr. 32: amps - ratng 013tlildrig oi,er 10,000 sq. ft.,
.*".'S.:'77 11" •',. 7 ,•-fr,•W:-:i:
_.,. • ; . •- , ••• .. • •-•,,.-: , • - . • - ..,--,,,- - ..., r.,n2,?!!:::,V..",n:Lq'tintl'9*Mt&titti of 1- and ?..faatly ( . wettings 4 or rrore 'ilew resident:a:
•. ..3 1- and 2 ily dwelling Ill ornmerciai/industrial 0 .A.ocesaory builcling n Qv" Gm votes 2°Millal Utl'IS in "4'4
...1 Mai-LW li Master baildor p Other EIBuikling t:n er thee stories 0 Feeders, 400 amps or 7-10PC
DO p
CCUpani loai. over 99,ersons EManufamired structures cr
)
''..":"': .1;• , •--. 1 • ',.: ;rt•,-e.% Li
'.,, .f - .7,7r717.7...:cg-,7,1:7“ , Egress/lighthi; RV pask
1 . 1 :J.". '• .',.;... ." - ,• .. . r......., .,- • . J. I...., ..,....,...., - ...s., pmr,
_ ..
4 ) 1:31b
,,iteibuivart, ao.: ' . . glAKION, - - a Dliealth-cere fazit.ty
310.:
Job site ,, i dre t04
ss: , InOther: -
" c2_ . 4 z
// ty/State/ZT?:' _ . vA Submit 2 set: of pion:: with any of Ow abovc.
. ri I I rifir le 1 I I ) .
- '. - at ,
ink ■ 6 .:. above aro nor app:icable to temporary constniFtion service
ject nam.i __ s)Lci..._ .
ir
.-...--- .---. f ktariptinn 1 qty- I it4., i ; TEIDI 1 '"
loss street/O irt ctions to job 8ite I New residantiUsiiigfa. or multi-family dwellinn_ mitt.
__ Includes attached garage. ____
1,000 sq. ft, or leis 14.
.3 5.15 j_ i 4
t ..,
_ , - ----
1. Lot no.: Ea_ 3131 500 us. fi. or portion
.--- 33.4d • 1 ]
-,-- - - Limited crierv, teside:nial 75.00 2
Fax :nap/parcel no.:
Linnted energy, tion-residntisl - 75.0 . ,
_
:- ', •:.7• u,',7,•ii )1 modular ,
li
.11 0. arlon, ir ro on MI ea A RCM sZEMPRO _ dwelling, setmee allot feeder 90.9a 2
Servtcas or fa ed.srs Installation, AU antr6elcati .
... : s' • -51111rEelitieall. 200 amps or less
- 1
ma 80.30 15(203)2
106.85: 2
-' : i ..-,.. ,,,,; ..:-. ' . ":1 • r" : ,.., . .1." " -:; ; ' .,, . • . . `...."...,".:-: '6'0 r , '..' • ; 1,1 '• '.
...f.'.,..: • '...,-..,, . , ? :: ----,. - _,. 1 , • • .' • ' ' . • '' ''' ' ' ''"''' '' ' ' ' -".". ' 401 amps to 600 stops 160.60 2
e pr_e_L_FI _ 601 amps to 1,000 amps - 240-60 i 2
- 7 ei 61,,) /2-___,k) 6048 ie.. . Over 1,000 asrps or volts
NM 454.65 2
---;_______-___- ReConnect only 66.65 1111111111 2
ity/State/ZI': / /6 #=1-- 'r ey 7 2- 7.- 5 -
Temporary strvicei a r feeders in‘tallation, altel'ation, and/or
--....-
relocation
4 L._ 200 anips or less I Cs:ET :
rwn installous This installation is being ma4e an property that I own which lS DA.IT 201 mops ',,o 400 arm:: 100.30 MI 2
.ttenticti for tall:, 'case, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps co 600 arnPs 133.75! 2
• )wner Sipat larin ate:
-.............-...-- D Brandi circuits.- now, alteration, or wension,:per panel
--....
, 11,. - " 4 ' . .';'...".' ' ..' 1: ' • ... ... ' .. :1,.... .. :. r '''', . . .. i .,,, .....1, ,...1... A. Fee for brar.a cil w its wim • 1
service or !ceder Coe, each 6.65 1 2
r =Ile: branch cirel rit -
...........,,..... B. Fee for brute. on ca its
..ontact maim without sonic: 9 fe,eder fee, 46.85. 2
each branct eirci!i.L
-+Adress: 6.65! 2
Each adclIbranch c
- . . I _ ,
'icy/State/a?: hliseettaceou:: ( or feeder not included)
' Pump or irrigation ciscle 3.40 I 2
11011.e: ( ) Fax: : ( ) 3 igri or oetlint lightirt. 53.4Q 1
Signal Pin:418(:s) or limited-.
3 Init • ':7- ' '' ' ::.5i7 ' 7..*".' .;- "i 7 " ..77. ''""" 1 '. - F , ....17:!. energy panel, ,ilrinalioil. or
,-!-'-,::.-_ , ! , , extension. Des crba. Pa 2 2
uSineas iiante
• ilki AP' 4AS . ........ L .
'.4driass: FLIT/700 "ktiimr: • e•
wtrOMM0.. Each additional In,p,etion over allowable in ally of the above
. ityStaterZi?: . 1 . OVI qDh .. a _ 0 investigation hr rcittiT I I 62.5C:
/,, ...--1 iJI Industrial plan t ter I Lip,ir _ _ _ 73
.L
sOB Lie.: Electrical Lic.:Z - . 4.
.1,it Subtotal 4IF 110 OP
4110
' ortr. Electrioi an signa re„ reqUired: Flan re.ciew (25% of pemli; fee)
1 .
---.-
Ii e sic (8% ry.f ptrrnit fOo) ,
4- L. 4 _
... xt. , r____ ... 4. 1 1 ... • )4 te . 7
------- - l TOTAL PERMIT FEE . AI . d .....
Adr .
, .12thorized . s: at Lange: This permit applIca. ion expires If a perrnit is aot atatAine • within I :o
-7- days at ir ltbas been accepted as compiew
'.• rint name: I Date: • Feb =chock, too it ty Tri•Coomy Ihtiliir.6 InduStryi 54r/iv; 3oarO
" Number of inspntimv: per permit agowed,
1..irdioecricia1BX Pcrumpp,clos inis3 440-451 SS( two2/C01,4)WEB
CITY OF TIGARD
BUILDING DIVISION ;. t' PERMIT #: ELC2005.00211
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/2005
A11 � 4
Phone: (5 03 ) 639-4171 n m
9 41 1 � Ipu����� 1
Inspection Requests (24 Hrs.): (503) 639 -4175 =,�
INSPECTION WORKSHEET FOR DATE: 4/8/2005 TIME: 7 :10AM PAGE: 28
SITE ADDRESS: 11795 SW GREENBURG RD CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: COMCAST
DESCRIPTION: Alteration of existing 120v servie #TGO5c2
OWNER: BLACK, STEVEN W + MELISSA R, PHONE #: 503 - 639-4201
CONTRACTOR: DRYER ELECTRIC INC PHONE #: 503-771-5667
Inspection Request Scheduled For: Date: 4/0/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 004118-18 503 -516 -3125 N
Corrections /Comments / Instructions:
•
I PASS _ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 Date: 4, - O ' Phone #: (503) 718-